Welcome to our media digest for the week of October 13, 2017! Each week PI compiles a round-up of the latest public health-related news, with an eye toward media framing and language, particularly as they relate to the role of primary prevention. The views expressed in these articles do not reflect those of Prevention Institute.

On Tuesday, EPA Administrator Scott Pruitt announced a proposed rule to repeal the Clean Power Plan. The Clean Power Plan was designed to cut carbon pollution from existing power plants by 32% by the year 2030. The Supreme Court put a stay on implementation in 2015. The Washington Post reports that “at least four Democratic attorneys general — from California, Massachusetts, North Carolina and Oregon — have pledged to challenge EPA’s proposed rule in federal court, along with environmental groups such as Earthjustice.”

This week, the Trump administration issued two executive orders to undermine the functioning of the Affordable Care Act health insurance exchanges and the quality and price of plans sold there. The first executive order would open the door to bare-bones health plans that don’t necessarily cover the essential health benefits required by the ACA. These association health plans and short-term policies could also be sold across state lines. The second executive order would cut off cost-sharing reductions payments from the federal government to subsidize insurance plans for lower income Americans that are purchased on the exchanges. The attorneys general of California and New York swiftly announced that they would sue the Trump administration to keep subsidies going. "I will not allow President Trump to once again use New York families as political pawns in his dangerous, partisan campaign to eviscerate the Affordable Care Act at any cost," New York Attorney General Eric Schneiderman said in a statement. "Our coalition of states stands ready to sue if President Trump cuts them off."

The New Yorker published an explosive investigation into rape, sexual assault, and sexual harassment allegations against Hollywood mogul Harvey Weinstein.

The Cook County board decided this week to repeal a soda tax that went into effect just two months ago. According to Vox, “The tax has been plagued, in its very short life, by legal challenges, implementation glitches and a screeching, multimillion-dollar media battle between the soda industry and public health groups. On Tuesday, in recognition of growing public pressure, the Cook County Board of Commissioners voted 15-1 to roll back the tax, effective as soon as Dec. 1. It's a major victory for Big Soda, which has spent millions on ad buys, lobbyists and political contributions in the county. It's also the second blow this year to the soda tax movement, which suffered a defeat in Santa Fe, N.M., in early May.”

President Trump threatened to reduce federal aid to Puerto Rico on Twitter Thursday morning, citing Puerto Rico’s debt situation and criticizing the state of the island’s infrastructure before Hurricane Maria struck. As of Wednesday, 89% of the island was without power and one-third of Puerto Ricans lacked access to safe drinking water. Food and medicine shortages are also widespread, and people are struggling to treat chronic conditions and prevent infectious diseases from spreading.

The National Academies of Sciences, Engineering, and Medicine has released a comprehensive report, Pain Management and the Opioid Epidemic: Balancing Societal and Individual Benefits and Risks of Prescription Opioid Use, along with a guide that includes recommendations for both advancing the treatment of pain and curbing the epidemic, including improving access to treatment, and to naloxone to reverse overdoses. Noting that “drug overdose is now the leading cause of unintentional injury deaths in the United States,” and that most overdose deaths involve an opioid, the report and guide also examine the interplay between prescription opioids and the use of heroin and synthetic opioids.

Wildfires in Northern California have killed more than 29 people, destroyed thousands of structures, and resulted in unhealthy air quality throughout the Bay Area. Among many firefighters and first responders are hundreds of California inmates who are paid $1 per hour to work on the frontlines of fire control. Wired reports on urban “smoke islands” – the ways cities trap smoke and polluted air: “Just as fire behaves differently in a city than it does out in the wild, so does smoke. Urban areas, with their concrete roads and walls of glass and steel, tend to stop a fire in its tracks. All those buildings and alleyways prevent wind from blowing fresh embers around. But those same aerodynamics mean that smoke gets trapped in cities. Liu’s latest research, which will appear in an upcoming issue of the American Journal of Epidemiology, found that metropolitan areas, even ones very far away from any actual wildfires, had much higher levels of particulate matter in the air than rural areas. An urban smoke island effect, if you will.”

New research finds that adopting the Affordable Care Act’s Medicaid expansion is associated with measurable drops in violent crimes (5% decrease), property crimes (3% decrease), and that counties that saw the biggest gains in Medicaid coverage also saw the largest drops in crime rates.

National Football League owners appear to be weighing a rule change that would force players to stand for the national anthem, which would penalize players protesting racial injustice and police violence.

A Maine girl whose family was shattered by drugs chronicles her experiences in the Bangor Daily News to encourage teens facing similar struggles to speak out, and others to listen. In what began as a middle school project, Hailey LeClair writes about depression, self-harm, and running away from home, along with deep friendships, forgiving, and healing. “I’ve never written anything like this before in my life,” she writes, “but I want people to know what it’s like to be the daughter of a stepfather and mother struggling with addiction, in a family full of addiction, and ultimately have to grow up sooner than I ever should have had to just to survive in my own home.”

NPR profiles an “opiate court” in Buffalo that fast tracks people appearing for opioid-related charges into treatment rather than criminal prosecution. The focus on treatment rather than incarceration is similar to the approach of other drug courts; what’s new is the emphasis on getting people into treatment as fast as possible, sometimes within hours.

While early lawsuits against drugmakers on behalf of patients harmed by opioid misuse often failed, plaintiffs’ lawyers representing municipalities are having—and anticipating—more success, according to a STAT profile of Paul Hanly, a New York lawyer representing more than a dozen cities and counties in lawsuits against the drug companies. States, cities, and counties are suing on the basis of the damages that opioids have wrought in their communities, alleging the drug makers stoked the market for painkillers and underplayed the risks of addiction. In the past, one challenge in the cases representing individuals has been that “Judges often viewed the patients as drug addicts,” the article says. Hurdles remain in the cases on behalf of local governments, including demonstrating that the drug makers, who received approval from the Food and Drug Administration for their products, bear responsibility for harm in a chain that also includes prescribing doctors and drug distributors, among others.

A medical doctor writing for Quartz calls for a public health approach to addressing gun violence: “By addressing the environments surrounding our neighborhoods, we can begin to pick up the pieces to help curb rates of violence in our country. Combatting poor living conditions and unsafe community spaces should be step one, and it can start with community programs doing simple things like cleaning up our parks, installing working street lamps and building proper and safe infrastructure.”

Last Friday, the Trump administration rolled back the requirement that health insurance plans provided by employers cover birth control: “To justify this rollback, the administration wrote pages into the new regulations that challenge well-established research on the health impact of birth control — from whether contraceptives reduce unwanted pregnancies to the harms and benefits of the Pill. Altogether, the case presented against birth control is a stunning distortion of the research on contraception. There is a long history of false information shaping women’s health law and policy — part of a broader push to curtail women’s reproductive rights in America. ‘[These birth control regulations] seem to be part of this larger effort to roll back women’s health care, roll back access to reproductive options,’ said Diane Horvath-Cosper, a fellow with Physicians for Reproductive Health. ‘It certainly looks like [the administration is] misusing science to that end.’”